Arrgghh.
I increased basals a notch. So now he's at 0.200 units per hour. This is doing nothing. I'm logging for the next few days to see what to do.
Tonight, I had gotten him down to a steady 115 (he'd been playing outside for a few hours). He had 2 chocolates (treat for site change - the lovely 4 carb Lindor truffles. I always picture Reyna throwing them at Joe when I give Adam one!), PB sandwich (sans crust) and half a banana. I dosed him at 6:30 for 35 carbs at his 1:30 carb ratio. It is now 9:30pm and he is 356.
More basal? Carb ratio changes? I know I really should just track religiously for a few days and email his endo, but of course, I want answers now. :)
I'm thinking also that his honeymoon is ending. When that happened for your child, did you notice this kind of thing, like the insulin isn't working?
Oh I totally get it - growth spurt, changes needed. This is life with a growing one. My gal is 8 and at times it can seem like I am bolusing water, that's a good one! Often I find that when I look back at the logbook I keep, I am not catching the high that will ensue - I am not setting temp basals or doing extend features, so we don't end up with a high in the first place. So, something sent him high - the bread, the banana, or his basal isn't enough. I go back to basal testing and see if that's right, then I move onto carb ratios and last I do insulin sensitivity. Does this help at all? I have SO been there. Good luck and hang in there!
ReplyDeleteYes, this is exactly what happened with Natalie! She was diagnosed the end of June and from then on we increased lantus and carb ratios every week. Seriously, I thought she was insulin resistant and kept asking the Dr. about that and their response was always, "she's probably coming out of her honeymoon and having a growth spurt". Now 8 months later, she has leveled off and we haven't made changes for almost a month. I now believe the whole honeymoon/growth spurt explanation because she grew over an inch and gained 3 pounds at her visit 3 months ago. Also, Natalie's carb ratios are 1/15 for breakfast and 1/17 for lunch and dinner and she is probably about the size of your son. She quickly moved from the 1/30 ratio to where she is now. (She is 5, and about 43 pounds.) Hope this helps. I completely understand your frustrations! Hang in there!
ReplyDeleteI have always kept records of everything I feed Andrew along with insulin given. When the doctor saw my records, she couldn't believe that I do all of that. To me, that is the ONLY way to know what's going on. If he would be spiking after a particular food, I would know to eliminate it. You are doing an awesome job! Keep the record keeping going!
ReplyDeleteBolusing water . . . hehehehehehe. That's a good one, Stephanie. Yes, that happens around here but Ellie is honeymooning too crazily (I know, not a word) and we can't correlate much, yet
ReplyDeleteHey there Stephanie, I just saw your post on CWD...a few ideas just popped up for me..
ReplyDeletefirst - have you done a CGM trial or does your endo's lend them out to get a better pic of what is going on?
second - could he be going low? You said he'd been running around and then you bolused him for food...I know that usually with Isaac those crazy upper 300's are either one of two things a miscalculated carb count or a rebound high. We've caught many rebound highs since starting CGMing, and what I mean by that is that he was having weird spikes at the same time and we couldn't figure it out despite testing every hour - popped the CGM in and bam he was going very low at those hours.
thirdly - basal needs may be increasing due to growth. Isaac's basal needs just skyrocketed over the winter he was at .025-.075 and now most of them are in the .15-.2 range...again the CGM helped us fine tune this.
Or, it's just d being d...darn pain in the butt.
I've really been doing my best to make big changes and then wait three days to see what is working and I only make one big change at a time so that I know which is really where the problem is. It's a pain in the patootey but has been working.
And I just saw something about Animas cartridges being recalled due to leaking I always wonder if little issues like this make a huge impact on our little guys whom are getting such little doses.
Take care :)
Thanks, Sarah! We actually do have a Dexcom, and have had one since December. Thanks to that, I'm sure he's not going low, in fact, for the last week, he hasn't been out of the 200's which is crazy.
ReplyDeleteI'm trying to be patient and get 3 days of good data before emailing it to his endo. I'm not sure where to start right now!
Hi Stephanie,
ReplyDeleteI just wanted to throw something out here.. Could he have eaten more carbs than what you thought?
sandwich - 30 carbs (our bread is 15g per slice), peanut butter - 3-6 (depending on how much), 2 truffles - 8, 1/2 banana - 6 - 12 depending on size/weight. I would come up with approx. 47g - 56g for his meal.
Don't you feel like a scientist, mathmetician and dietician all in one???????